In close collaboration with childhood cancer stakeholders over three decades, POGO has helped to implement and support a highly integrated, coordinated childhood cancer care system by developing comprehensive Provincial Pediatric Oncology Plans (PPOPs) in 1988, 1994 and 2006, and a progress update in 2011. The successive Plans have been endorsed by Ontario’s Ministry of Health and Long-Term Care (MOHLTC) and are widely recognized as the definitive system plans. The next long-range planning exercise, for 2017 – 2022, is well underway.

POGO PPOPs have generated an accessible service system that anticipates and continually adjusts to facilitate the ever-advancing frontier of childhood cancer control. POGO’s objectives in this regard are to promote optimal access to equitable care; participate in knowledge creation and dissemination; and to re-envision the system continuously, ensuring it has the capacity to deliver state of the art cancer care for children. This work is undertaken in concert with many stakeholders and partners—including policy makers, parents, survivors, hospital administrators, pediatric oncologists, pediatric oncology nurses, social workers, psychologists, child life workers, pediatric pathologists, radiologists, community services, and tertiary (university linked) and community hospitals.

POGO launched the 2017 – 2022 planning process with a Thought Leaders’ Day on March 1, 2016. Deliberations of 50 thought leaders were distilled into eight priority areas for further investigation by working groups tasked to identify major gaps, efficiencies, upcoming opportunities and challenges in these areas. More than 200 stakeholders have been engaged in regular meetings on discrete topics, and numerous other experts consulted as needed. Since March 2016, 31 committees have been actively pursuing recommendations in assigned component topic areas, supported by POGO staff. The broad-based, grassroots-up consultation is overseen by a 40-member advisory group responsible for assisting and advising PPOP working groups, and for the preparation and submission of a concise but comprehensive 5- to 7-year action plan.

In the course of successive long-range Plans, POGO has identified significant concerns and developed solutions leading to a well-coordinated provincial system. For example:

A major outcome of the 1988 POGO Plan was the recognition of childhood cancer as a distinct, high acuity and high-cost area of activity requiring coordination.

POGO’s 1994 Plan led to dedicated, equitable, multi-disciplinary pediatric oncology teams in all POGO partner hospitals as well as new service delivery models, e.g., POGO Satellite Clinics, a provincial network of well-prepared units in community hospitals to which clearly identified areas of childhood cancer care could be devolved for delivery according to well-defined standards; and a provincial network of POGO AfterCare Clinics to monitor and ameliorate survivor late effects of cancer in childhood.

The 2006 Plan:

addressed the need for supportive care guidelines (a significant gap in the field) to promote best practice, efficiencies, and consistency and equity of care;

a process for expedited access to state-of-the-art treatment protocols through a provincial research approval mechanism;

the development of 21 standardized indicators to assess the quality of childhood cancer care delivery which have been enthusiastically endorsed by all hospitals; and

the capability to test for Minimal Residual Disease (MRD) in Ontario, which was previously done in the USA.

The pediatric oncology community of Ontario, working as the POGO collaboration, has achieved the evolution of childhood cancer care from isolated hospital program activity to a highly integrated and comprehensive provincial system.

The work of Pediatric Oncology Group of Ontario (POGO) has
resulted in a highly integrated childhood cancer system that delivers equitable
care, accessible to families living across the vast
geography of Ontario. POGO receives core funding from the Ministry of Health
and Long-Term Care. The organization serves as the official source
of advice on childhood cancer to Ministry of Health and Long-Term Care; has
been a long-standing leader of a collaboration among Ontario’s academic
pediatric oncology programs and other stakeholders; and has become a trusted
source of information among colleagues, parents, survivors and the public. An
engaged and supportive donor base provides additional funding for POGO research
and family shield services.